Christian Ezeala Receives Professional Recognition

Congratulations to Christian Ezeala (SAFRI 2008) on being awarded Professional Membership in the Institute of Clinical Research (MICR) of the United Kingdom, and on receiving Chartered Scientist (CSci) status from the Science Council in London.

Elizabeth Wasserman Awarded Full Professorship

Congratulations to Elizabeth Wasserman (PHIL 2002), who was recently awarded full professorship in the Department of Medical Microbiology at Stellenbosch University. Prior to this appointment, Elizabeth held an associate professorship through the National Health Laboratory Services. She has also served as Head of the Medical Microbiology Division for three years.

Congratulations to Nalin Mehta (PSG 2007), who reports that he has been selected to serve on the Wolters Kluwer/Lippincott Williams & Wilkins South Asian Advisory Panel for the specialty of Physiology. Nalin also announces that he has been commissioned to write two textbooks; one on Bioethics and the other on Physiology.

Naranchimeg Sodovsuren Announces Publication of Her Third Book

Congratulations to Naranchimeg Sodovsuren (PHIL 2006), who recently announced the publication of her third book, entitled I Want to Be a Good Doctor. The book’s content is focused on professionalism, critical thinking, teamwork, and research techniques. Naran also reports that her education innovation project, “Developing a model for the teaching and assessment of professional attitudes in undergraduate medical education,” has been implemented very successfully at her home institution in Mongolia.

Reem Rachel Abraham Receives “Teaching Career Enhancement Award” from the American Physiological Society

Congratulations to Reem Rachel Abraham (PSG 2007), who recently received a “Teaching Career Enhancement Award” from the American Physiological Society. The year 2008 has been a very busy one for Reem, who attended the 5th Asia Pacific Medical Education Conference (APMEC) in Singapore in January, where she presented a paper entitled “Learning approaches of undergraduate medical students to physiology in a Non-PBL (NPBL) and a Partially PBL (PPBL) oriented curriculum.” Reem reports that she has also published the following papers:

Supten Sarbadhikari Teaches Health Level Seven e-Learning Course

Supten Sarbadhikari (PSG 2007) reports that he has become an e-teacher for a Health Level Seven (HL7) e-learning course, teaching students from North America, Europe, Asia, and Australia. HL7 is a Standards Developing Organization operating in the health care arena. Supten is also currently serving as Chair of the Editorial Council of Citizendium, Member of the Editorial Board of the Elsevier journal Mental Health and Physical Activity, and Editor-in-Chief of the Open Access Indian Journal of Medical Informatics. He reports that he is presently setting up the Department of Biomedical Informatics at PSG Institute of Medical Sciences and Research, Coimbatore, India. Supten also reports the following recent publications:

Eliana Amaral among FAIMER Leaders at Middle-West Congress on Medical Education in Brazil

Eliana Amaral (PHIL 2003) reports that the August 2008 Middle-West Congress on Medical Education led by 2007 Brazil-FAIMER Fellow Vardeli Alves de Moraes and 2008 Brazil-FAIMER Fellow Edna Regina Pereira, both from the Federal University of Goias, was a huge success, with 680 registrations (faculty and students). Dione Tavares Maciel (BRAZ 2007), Derly Silva Streit (BRAZ 2007), Regina Lugarinho da Fonseca (BRAZ 2008), Suely Grosseman (BRAZ 2008), and Paulo Carvalho (PHIL 2006) also made important contributions to the meeting. Eliana led a session on program evaluation and research in medical education and coordinated a second workshop on faculty development and student assessment methods.

Valdes Bollela Returns to His Own Medical School as Medical Manager of Outpatient Clinic

Valdes Bollela (PHIL 2006) reports that in July 2008, he was hired to be the medical manager of the outpatient clinic of the Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMRP-USP). Valdes explains that it is a university hospital with more than 7,000 people working there every day (employees, residents, teachers, and support staff). “Every day we see more than 2,500 patients in our outpatient clinic and we are the reference for high-complexity medical assistance in the Northeast Area of Sao Paulo State,” he reports. Valdes shares that he is especially happy to be at HCFMRP-USP because it is where he completed his medical and postgraduate education. He reports that he has an opportunity to use something from the FAIMER “toolkit box” on a daily basis, especially the conflict and change management tools.

Paulo Carvalho (PHIL 2006) reports that his school, Faculdade de Medicina de Marília, is organizing a national meeting about active teaching-learning methods in undergraduate health sciences. It will be held August 21-22, 2009. They are expecting 870 participants and have received 124 papers. Many Brazil-FAIMER Fellows will be among the meeting’s workshop facilitators.

Jyoti Nagmoti is Named Director of KLE University Department of Education for Health Professions

Jyoti Nagmoti (PSG 2007) happily reports that she has joined as Director of KLE University’s Department of Education for Health Professions. She reflects that this achievement would not have been possible without the help, sharing of information, and effective mentoring of her FAIMER family.

Bishnu Hari Paudel (PHIL 2007) reports a positive development at B.P. Koirala Institute of Health Sciences in Dharan, Nepal. The Vice Chancellor and the Rector have recognized several FAIMER Fellows on the Institute’s faculty, and have given them the responsibility of leading, strengthening, and revitalizing the activity of its Health Professions Education Department. Bishnu reports that a Core Group of five members was established in June 2008 with this goal in mind and that he, Soumya Bhattacharya (PHIL 2005), and Shyamal Bhattacharya (PHIL 2006) were among those selected for the group.

Tejinder Singh (PHIL 2003) is staying busy taking part in faculty development in India. In July 2008, he was invited to conduct an advanced workshop in health professions education in Pune, India. In August 2008, he conducted a workshop on problem-based learning (PBL) at Datta Meghe Institute of Medical Sciences University in Wardha, India. Tejinder delivered a guest lecture on faculty development at SS Medical College, Rewa, in September 2008, and a guest lecture on “Medical education – adding science to an art” at DY Patil Deemed University, Mumbai, in October 2008.

As part of his FFFP fellowship, Jehu spent six months at Bowman Gray School of Medicine (later renamed Wake Forest University School of Medicine) in Winston-Salem, North Carolina. While at Bowman Gray, Jehu worked with Gwendie Camp, Ph.D., Associate Professor, Office of Education Research and Services, and observed the school’s problem-based learning (PBL) curriculum. Upon his return to his home institution, Jehu was successful in implementing a problem-based, community-based medical curriculum, the first of its kind in South Africa. Despite challenges that include shortages of human resources and of facilities, the PBL curriculum that he initiated has flourished over the years. Today, the Faculty of Health Sciences at Walter Sisulu University is a World Health Organization (WHO) Collaborating Centre for Problem Based/Community Based Learning in Health Sciences, and the Faculty’s PBL initiative “is the leading innovative program in the sub-Saharan Africa,” according to Jehu.

Part of the reason for this success is the University’s commitment to self-evaluation. “Our approach to the PBL/CBE [community-based education] curriculum has been like one big research project,” explains Jehu. “We have continuously monitored the implementation of the program.” Jehu’s FFFP mentor Gwendie Camp has twice traveled to University of Transkei to evaluate the PBL program; one of these trips took place as part of a fellowship through ECFMG’s former Short-Term Exchange Fellowship (STEF) program. Jehu also has reported on the PBL program through several papers published in peer-reviewed journals and in numerous presentations at international meetings.

Today, Jehu is Professor of Physiology, Chair of the Department of Physiology and Medical Biochemistry, and Chair of the Quality Assurance Committee of the Faculty of Health Sciences at Walter Sisulu University, where he has taught for 20 years. Over the years he has also served as Chair of the University’s Curriculum Committee and the Undergraduate Education Committee. Jehu is a member of The Network: Towards Unity for Health and serves on the Editorial Boards of several journals, including the South African Medical Journal. He also has been involved in curriculum reform in South Africa, Ghana, and Uganda.

According to Jehu, the FFFP program has had a significant impact on his career. “The FFFP program helped me grow professionally. I was already a full professor by the time I took the fellowship, but the various positions that I have held at the institution (chair of various committees), nationally (member of the accreditation committee of the Health Professions Council of South Africa), and internationally (a consultant in medical education to WHO and other organizations) was in large part due to the expertise that I acquired during the fellowship,” he states.

Looking forward, Jehu plans to focus on ensuring the sustainability of Walter Sisulu University’s PBL program and spreading this innovative educational approach to other sub-Saharan African institutions. This year, he will be on sabbatical, working with a new institution in Uganda called Busitema University, where he will help the University start a Faculty of Health Sciences. He will also spend time with the University of Development Studies in Tamale, Ghana, where he will assist with a similar program.

Nor Azila Mohd Adnan, Ph.D., a FAIMER Fellow from the 2002 Institute class, has worked at the Universiti Malaya since 1981 in a number of capacities, including Year I medical course coordinator (1992-1993), deputy dean (1994), Phase I coordinator of the New Integrated Curriculum (NIC) (implemented in 1998), and problem-based learning (PBL) coordinator and chair of the PBL committee (2000-2007) of the Faculty of Medicine. Azila’s education innovation project during her Institute fellowship was to Increase and Improve Implementation of Problem-Based Learning.

Azila says that PBL is not new to the Universiti Malaya. During an e-mail interview, she shared some of the PBL-related stumbling blocks and successes her institution has encountered.

The proposal to introduce PBL as part of the learning approach in the NIC became moot when discussions on curriculum review started in 1996. The decision on curriculum review was based on information obtained from a survey (carried out in 1994) of the evaluation performance of our graduates working as interns in the Ministry of Health hospitals, by the consultants who supervised them. To improve graduate outcomes a curriculum review was done, weaknesses and strengths were identified, and corrective measures were proposed with the results of the survey taken into account. In short, an integrated curriculum was proposed, with three vertical strands: Scientific Basis of Medicine; Personal Professional Development (PPD); and Doctor, Patient, Health and Society (DPHS), identified to ensure a holistic and patient-oriented doctor as the product of our education, with PBL as a feature in the students’ learning approach.

As part of the curriculum review, several staff members served on systems committees that worked toward improving deficiencies of the previous curriculum with the development of the PPD and DPHS strands. However, little attention was given to how PBL should be utilized. For the latter it was more of the “hammer” rather than the “induction-campaign” approach. The decision to introduce PBL as a curricular approach was not fully supported by faculty, although an introduction of some trial PBL tutorials into the second year (Phase II) was allowed. It was left to the Phase II coordinator, with help from a few of us, to introduce the PBL tutorial format in 1999 within the systems module. In 2000 PBL tutorials were introduced in some systems in year 1 (Phase I). Thus, in a way, PBL was used as a tool in teaching-learning rather than a curricular approach and content lectures were given after the cases had been discussed.

In that same year a new Dean and Deputy Dean of Undergraduate programme were appointed. Subsequent to that the PBL committee was formed (in 2000) and I was appointed as chair. Although our committee, with the Phase coordinators, was expected to help maintain running the PBL tutorials, not much authority or mandate was given to progress further in trying to increase the use of PBL within the NIC. We also did not know how PBL should be implemented or what a PBL curriculum should entail.

If the implementation of PBL was to be evaluated in its purist form, where there is “true” independent learning with problems/cases as the trigger to learning as described in the literature, then I would say that our implementation of PBL was not quite successful, since the first two years of the curriculum are still lecture-based, as far as learning of content is involved, and too few cases are used. However, since the cases are discussed before the systems lectures are given, there are positive outcomes seen and some progression in that the students are: showing more independence with the ability to obtain and learn some of the information; becoming more vocal and critical in opinion; showing integration in learning, thus supporting the organ-systems approach; beginning to consider social-behavioural issues; and becoming more patient-oriented. This also helps to strengthen the vertical integration between the preclinical and clinical sciences and integration amongst the preclinical disciplines.

The goal of my FAIMER Institute project was to try to progress further by increasing the number of cases used to trigger learning and to reduce lectures on the related topics with a long-term plan of modifying the curriculum gradually. In one aspect, this was achieved when faculty agreed to a “trial” implementation of a four-week gastrointestinal tract (GIT) module coordinated by a colleague, Professor Cheah Swee Hung, in session 04/05, using the case-based learning (CBL) approach. During the four-week period, students learned by working through two long cases, six short cases, and several self-study cases, with content lectures reduced drastically.

Progress was achieved using the “persuasion/campaign” approach, which I learned from my FAIMER Institute experience. Various strategies such as staff development and sharing ownership were used. The CBL-GIT module was continued in sessions 05/06 and 06/07. However, due to critical staff shortage, the CBL approach was shelved for session 07/08.

My FAIMER Institute experience has had some impact on my career progression. It was and still is a valuable learning experience and has made an impact on my view of and approach to medical education, and the events that occurred in terms of curriculum and staff development. I was able to give better, more knowledgeable input in regards to faculty education and staff development, and became a mentor to many of my younger colleagues. To a certain extent, I am regarded as the resident expert in medical education.

Azila was considered for a position in the Ministry of Education in 2004, but the Dean of the university offered a more senior member of faculty for the position, so that Azila could uphold her tasks as a member of the faculty. In January 2007, she was offered the position of Deputy Director of the revived Universiti Malaya Learning Improvement Centre (UMLIC) for the whole university; however, she declined the offer as it would mean moving away from her faculty, medical education, and FAIMER.

Azila received staff excellence awards conferred by the University in 1998, 2000, 2002, 2004, and 2005. Azila’s plans for the next two to three years, with the help of key staff members and other FAIMER Fellows, are:

to update and help the New Deputy Dean look into several issues related to the curriculum;

to help the Deputy Dean reactivate the proposal to establish a medical education unit;

to increase staff development programmes through various committees and, after the medical education unit is established with core members, ensure that these activities are in place, and that curriculum development and implementation is coordinated and monitored with regular programme evaluation; and

to reactivate capacity building.

Azila has initiated a research project with her colleagues within the faculty, since her fellowship, and has obtained funding from the Intensified Research Priority Areas (IRPA). The focus of the project is on the development of performance indicators, which includes the development of OSCEs, analysis of the MCQs, and the continued monitoring of the performance of graduates at the 23 general hospitals during their pre-registration house officers (PRHO) period.

Azila is involved in a host of national and international activities and was an invited guest speaker or facilitator at many of them. She was appointed or elected as: Vice-President of the Asia-Pacific Association on PBL in Health Sciences (APA-PHS) from 2006-2008; member of the International Advisory Board for APC-PBL since 2005; country representative in APA-PHS, 2002-2006; and member of the International Survey Team to audit the Aga Khan University Undergraduate Medical Programme according to LCME standards (in December 2006). In 2006, Azila was involved in the national seminar, “Staff-student ratio for Undergraduate Medical Programme,” which was organized by the Ministry of Education.

Azila has become an unofficial recruiter for the FAIMER Institute. She recommends the FAIMER Institute to colleagues and includes a note in her slide presentations about the Institute. She has even requested time at a conference to present information on FAIMER.

Azila remains involved with FAIMER and her Institute fellowship class. In 2005, she was selected as a Fellow in the FAIMER International Fellowship in Medical Education (IFME) program and received full financial support from FAIMER to pursue a master’s degree in health professions education (MHPE). Azila received a postgraduate certificate in medical education from the University of Dundee in March 2006. Azila also co-authored “Accreditation of undergraduate medical training programs: Practices in nine developing countries as compared with the United States,” which appeared in the July 2006 issue of Education for Health. Azila was invited to participate in the 2007 FAIMER Institute as a Global Faculty Discussant (GFD). GFDs provide materials and insight gained from their MHPE programs and other professional experience during the planning and implementation of the Mentoring and Learning Web (ML Web) on-line discussions.

Currently Azila is taking a year’s unpaid leave to provide care for her ailing parents.

For most incoming Fellows, the FAIMER Institute marks the beginning of what will hopefully be a long and productive association with the Foundation. But for one member of the 2007 FAIMER Institute class, the Fellowship is just one more facet of an already established collaboration with the organization.

Payal Bansal, M.B.B.S., M.S. (Surgery), P.G. Dip (Health Education), of Pune, India, has been involved with FAIMER since 2004 when she was awarded a Fellowship through FAIMER’s International Fellowship in Medical Education (IFME) program. As part of her IFME Fellowship, Payal spent one year studying in residence at the University of Michigan Medical School, Ann Arbor, Department of Medical Education. Through her Fellowship, she wanted to equip herself with a wide array of educational tools to enable her to initiate meaningful and need-based educational reform that would help to meet the challenges facing medical education in India. Her Fellowship allowed her to participate in a variety of teaching and learning activities, including courses taught by Medical Education Department faculty as well we the school’s Medical Education Scholar’s Program and Standardized Patient Program. She also learned to construct standardized assessments, which allowed her to successfully implement an assessment for new entrants into a post graduate surgical program when she returned to India in May 2005.

In February 2007, a paper based on this project, “From a ‘Generalist’ Medical Graduate to a ‘Specialty’ Resident: Can an Entry-level Assessment Facilitate the Transition? Assessing the Preparedness Level of New Surgical Trainees,” which she co-authored with 2003 FAIMER Institute Fellow Vivek A. Saoji, M.B.B.S., M.S. (Surgery), and her IFME mentor Larry D. Gruppen, Ph.D., won the Best Oral Presentation (Merit) Award at the 4th Asia-Pacific Medical Education Conference. The paper was subsequently published in the Annals, Academy of Medicine, Singapore (Ann Acad Med Singapore 2007;36:719-24).

Payal also has had the opportunity to pursue the goals that drew her to the IFME program in the first place, namely identifying ways to improve medical education in India. In October, a paper she co-authored with 2002 FAIMER Institute Fellow Avinash Supe, M.B.B.S., M.S., “Training of medical teachers in India: Need for change,” was published in the Indian Journal of Medical Sciences. She also has been heavily involved with FAIMER’s Regional Institutes over the last two years, currently serving as a faculty member for the GSMC-FAIMER, CMCL-FAIMER, and PSG-FAIMER Regional Institutes. Through the Regional Institutes she leads discussions on assessment, group dynamics, and project planning, and facilitates assessment discussions on FAIMER Fellow listservs.

Payal’s involvement with FAIMER continued in October 2007 when she became a member of the 2007 FAIMER Institute class, a fellowship she sees as an opportunity to cultivate some very important skills. “I feel that the Institute is a great learning experience,” explains Payal. “I spent a year learning about medical education but felt I still needed to improve my skills in group work and some aspects of leadership.” For Payal, who has spent so much time teaching teachers herself, participating in the FAIMER Institute has an added benefit: The chance to observe the process in action and gain a better understanding of how sessions are conducted at the FAIMER Institute—learning that will inform her work with the Regional Institutes.

Payal also feels that her FAIMER experiences will aid her as she undertakes her newest endeavor: an associate professorship in the Department of Medical Education at the Maharashtra University of Health Sciences, a university that has a number of health professions schools under its umbrella and is affiliated with Seth G.S. Medical College, host to the GSMC-FAIMER Regional Institute.

According to Payal, she was attracted to this new position because it offers her the opportunity to be involved in the shaping of a young department—it was just eight months old when she joined its ranks in December 2007—and the opportunity to make a difference within India’s health care system. “My interest in medical education has increased so much I would like to give it as much of my attention as possible,” she states.

Looking forward, Payal is excited about the opportunity to share what she has learned at the Institutes with the faculty in her new department, and to implement her education innovation project, “Establishment of priorities and strategic direction for a new department of medical education at a health science university using a 360 degree stakeholder assessment.”

For Payal, the FAIMER experience is more than just a highlight on her impressive CV. “The first time I saw the FAIMER concept map, it aligned so closely with what I want to see in my country—it’s like having an ally who shares your vision,” she says. “And as I worked with FAIMER, I became part of the process contributing to that change. I use a lot of what I have learned and continue to collaborate to move toward that shared vision.”

Former IFME Fellow Medha Joshi Reports on International Conference on Medical Education

As noted in the October 11, 2006 issue of FAIMER MedEd, the International Conference on Medical Education was held in Bangalore, India, from January 26 to 28, 2007. The following was submitted by Medha Joshi, a 2000-2001 FAIMER IFME Fellow, who served as the secretary of the conference’s organizing committee:

We express our sincere thanks to FAIMER for its wholehearted support and encouragement in the conduct of the International Conference on Medical Education at M.S. Ramaiah Medical College, Bangalore, by giving coverage for the event in your e-newsletter.

The consultation workshop on the 26th of January 2007 was attended by over 50 medical educationists from India and abroad. A wide range of topics was discussed, with emphasis on community-oriented teaching, integrated teaching and distance learning in medical education.

The International Conference held on the 27th and 28th of January 2007 was a resounding success, according to feedback from the participants. The conference was well attended, with a total of 185, 15 of whom were from outside India. There was a series of invited lectures, panel discussions, and paper and poster presentations. Relevant topics like innovations in teaching and learning methods, innovative curricula in health professions education, student assessment, developing a research culture, and programme evaluation were discussed in detail. The delegates had ample opportunities for interactions. There were 50 resource persons for the consultation workshop and the conference from different parts of India and six from countries outside India; five of the resource persons were fellows of FAIMER Institute, Philadelphia.

The long felt need for networking among medical educationists was given utmost priority by organizing a session to work out the modalities. Dr. S. Kumar, Dean & Principal of M.S. Ramaiah Medical College welcomed the idea of networking and assured a seed money for this initiative. Initially it was decided to network medical educationists in India but it later extended to all over the world. It was decided to set up a consortium of medical educationists. An ad hoc committee was formed to work out the modalities and go ahead with the process of networking.

The Conference banquet and dinner was arranged at Hotel Atria. The delegates appreciated the initiative of the Medical Education Cell of M.S. Ramaiah Medical College in organizing the conference and expressed the need to have such conferences on a regular basis for meaningful interaction and updating the knowledge about developments in medical education.

To commemorate this important event, a souvenir containing the invited articles, guest lectures, and abstracts of the presentations was released.

We look forward to your continued support and encouragement in all our future endeavours in furthering the cause of medical education.

Medha spent her six-month fellowship in the Department of Medical Education at the University of Illinois at Chicago studying student assessment, competence assessment, theories and models of program evaluation, and faculty assessment. After a brief return to M.S. Ramaiah Medical College in Bangalore, India, she returned to the University of Illinois at Chicago to complete her Masters in Health Professions Education program in 2005.

FAIMER Fellow Juanita Bezuidenhout Earns Ph.D. for Her Dissertation on Cytokines and Tuberculosis

In December 2005, Juanita Bezuidenhout, M.B.Ch.B., M.Med. (Anatomical Pathology), received her Ph.D. from Stellenbosch University in Stellenbosch, South Africa. A FAIMER Institute Fellow from the Class of 2005, Juanita is currently a principal pathologist and associate professor in the Department of Pathology, Division of Anatomical Pathology at Stellenbosch University and the National Health Laboratory Services. Her Ph.D. dissertation was entitled, "Cytokines and Tuberculosis: An Investigation of Tuberculous Lung Tissue and a Comparison with Sarcoidosis."

Juanita shared the following reflections on the significance of her dissertation and the relation it has to her overall career:

Tuberculosis is one of the most common diseases in the developing world, with serious morbidity, mortality, and socio-economic implications. To understand the pathogenesis of this disease and its interaction with HIV lies at the heart of solving the problem. I investigated a small, specific area in the pathogenesis of granuloma development in tuberculosis in HIV-negative and positive patients and patients with sarcoidosis to determine whether the relationship between the four fundamental cytokines in granuloma formation changes in situ in these different scenarios. My conclusion was that the effect of a cytokine depends at least partially on the stage of disease and that the balance between the various cytokines and the levels of these cytokines contribute to their role in resolution or disease progression. Therapeutic modulation of these cytokines may contribute to treatment and reduce the destructive effects of tuberculosis.

My interest in tuberculosis and granulomatous disease was triggered by my exposure to pulmonary pathology as part of my responsibilities in our department and it was a logical step to develop a responsibility into a Ph.D. It also slots in with the faculty research focus on HIV and tuberculosis and forms part of the Desmond Tutu TB Centre's research activities. In addition, to be considered for the position of associate professor, a Ph.D. is required. Additional Ph.D. theses have developed from my original thesis, thereby sustaining my contributions to research in this field, resulting in the development of my career in terms of congress presentations, publications, etc. I am currently co-authoring two chapters in an inter-nation tuberculosis textbook. Most importantly, I have developed research skills and learnt invaluable lessons regarding the research process, and also about human relations and communication.

Asked how her dissertation has impacted her role as a medical educator, and how it will impact her career focus over the next few years, Juanita reflected:

Once you have been through the process of producing a thesis, you have an understanding that comes with experience. This is of immense value as a medical educator, especially since I am mainly involved in postgraduate education. The insight into the research process, but also the human interactions, is invaluable in working with postgraduate students. Although the topic could not be further removed from medical education, the essence of the skills are the same.

As most other medical academics in South Africa, I have to focus on service, research, and education, as these are requirements of my appointment. Although my participation in tuberculosis research will continue, I now also have responsibility for the gastrointestinal (GIT) pathology in our department, and that has opened several new research doors. Of course, since 2002, when I first received the award for the best scientific exhibition in the faculty, for an exhibition about the clinical rotation in pathology, and later received the Rector's Award for Teaching Excellence, my main focus has been medical education. Apart from continuing with my FAIMER project on establishing a national framework for postgraduate pathology training, I intend to be active in the newly established Centre for Health Sciences Education as well as the Southern Africa Regional FAIMER Institute. I am chairperson of the newly established education committee of the Pathology Department (including all six pathology divisions) and I want to focus on developing this into an active research and development group on both under- and postgraduate levels.

As an Institute Fellow, Juanita developed an education innovation project entitled, "A National Framework for Specialist Training – Start with Pathology?" She shared the following reflections about her FAIMER experience:

I learnt many things through the course of FAIMER and my project. Research skill, project management skills, communication skills, etc, but the best take home lessons were the less tangible ones: To trust my instinct. Keep close and continuous contact with my found pilots. We all need each other.
Do not try to do everything on my own. There is always support and help available. I sometimes just need to look harder for it. Always pre-empt as much as possible (in cricket terms – cover all your wickets) and address before it becomes a problem. Have alternative solutions ready on the back burner.
Be careful about what you say in public, but also be prepared to take that calculated risk. Know how to apologise. Because things are done electronically, doesn't necessarily mean the information is easy to access.

I sometimes look back at where I am now and think: "for somebody who gave up medicine in my third year, only to return two years later, I have come much further than I anticipated then." But then, there is so much more to do!! I want to do everything. The main challenge in education in our institution is probably human resources. We are constantly required to provide service, do research, and be educators. At least research and education can now be combined. I believe that a greater awareness of the "research side-effect" of education may entice more people into education. This of course immediately elicits a philosophical debate, which I am sure David [Cameron, also an Institute Fellow from the Class of 2005] will love, but I believe that it is one of the ways to entice people into education.

Medical education and innovation is crucial in meeting the health needs of our communities. The shift in focus from knowledge-based tertiary environment learning to outcome-community-based learning would not have happened if not driven by medical educationalists. The awareness and the insight that goes with, for instance, portfolios, add a dimension to learning that was previously completely neglected. If I had to highlight one way in which FAIMER has changed me, it is to consciously reflect. By nature I have always been reflective (INFP), but to reflect with true purpose AND to constructively act on that, I became skilled at through FAIMER.

I believe that the FAIMER community adds value to medical health and education in so many ways, most of which are often hidden at the time of the experience. To be part of this community is an honour and a privilege.

FAIMER Fellow Christina Tan Awarded Fellowship of the Royal College of General Practitioners

On November 17, 2006, FAIMER Institute alumna Christina Tan, M.B.B.S., M.R.C.G.P. (U.K.), F.R.C.G.P. (U.K.) was awarded a Fellowship of the Royal College of General Practitioners (F.R.C.G.P.) by the Royal College of General Practitioners in the United Kingdom. Christina is a Fellow from the 2005 Institute class. The F.R.C.G.P., the highest grade of membership in the College, is widely respected and valued, and represents an important honor for the member involved. The College has nearly 25,000 members, of which one in eight are Fellows.

In his speech at the awards ceremony, Professor Roger Neighbour, President of the Royal College of General Practitioners, described some of the key criteria used when awarding Fellowship: "A Fellow is someone who has made a contribution to patient care, to the College or to the discipline of general practice significantly over and above what might reasonably be expected of any Member of the College. In this sense, Fellowship signifies that the Fellow has brought ‘added value’ to his or her career. Fellowship can be merited both by the breadth and the depth of achievement. Some Fellows earn recognition for contributions made in a number of areas and over extended periods of time. For others, Fellowship is an accolade marking outstanding and far-reaching achievement in a relatively narrow field. A Fellow of the College exemplifies its motto ‘Cum Scientia Caritas,’ and is an ambassador for the College’s standards and values in whom the College is happy to signal its pride."

When asked about her FRCGP award and its significance in her career as a physician, Christina shared the following reflections:

When I graduated from the Royal London Hospital Medical College, I did not think I would take up a career in general practice (also called family medicine or primary care medicine). At the time, I was an aspiring obstetrician and gynaecologist, and worked towards this, taking up training jobs in the United Kingdom in Obs & Gynae, general and neonatal paediatrics, and even a six-month spell in a genitourinary medicine clinic. Then it occurred to me that when I reached the age of 50, I did not want to still be getting out of bed in the middle of the night to perform C-sections to deliver babies. However, as a compromise, since I still loved Obs & Gynae, I thought my next best option would be general practice. So I changed tracks at that time, and have never looked back since.

For ten years I worked in the National Health Service (NHS) in the United Kingdom. This included four years as a partner in an inner city general practice in southwest London. I finally decided to come home to Malaysia in 1995, mainly for family reasons, but also because I had an opportunity to join the University of Malaya as a young lecturer in a very young department of Primary Care Medicine. I have now been at the university for the last 12 years and, during this time, have been very involved in teaching undergraduates and delivering vocational training for Family Medicine. The University Malaya Medical Centre (where I am based) and the Faculty of Medicine of the University of Malaya jointly obtained the ISO 9001:2000 certification for quality in 2002. This is a management tool for ensuring compliance with internationally recognised standards of delivery of two major products, teaching and health care. Our department has worked hard towards the development of high standards of communication and inter-professional team work in order to provide an excellent environment for both under- and postgraduate training.

So, for me, this Fellowship award is synonymous to having one of the greatest compliments your peers can pay you, by saying how much they admire you. I hope I have fulfilled the criteria for Fellowship in making a significant contribution to the health and welfare of the community, the science or practice of medicine, and the aims of the College which directly or indirectly benefit general practice.

As a medical educator, my primary aim has been to raise the standards of patient-centred holistic care by being involved in undergraduate M.B.B.S. (Bachelor of Medicine & Bachelor of Surgery) and postgraduate (Masters of Family Medicine) education. I have contributed to the M.B.B.S. programme by helping to introduce and develop teaching in problem-based learning, communication skills, behavioural sciences, and medical ethics. In the postgraduate programme, I have been involved in further training in these holistic skills and preparing trainees with a sound and comprehensive training in Family Medicine. The standard of graduates emerging from these programmes ensures that both regional and national standards are raised.

I have also made a major contribution to the assessment programme at both undergraduate and postgraduate levels by (a) setting and marking written Final M.B.B.S. examination papers and coordinating the Final M.B.B.S. Objective Structured Clinical Examination (OSCE) twice a year (OSCE is also used in the Masters of Family Medicine examinations), and (b) working with two other public universities in Malaysia to develop and assess a four-year programme to train doctors to provide a high standard of service in primary care services across Malaysia.

In an age of constantly developing technologies and advances in medicine, the demands made on the clinician to provide higher standards of care are greater. As Professor Roger Neighbour said at the FRCGP awards ceremony, "General practice or family medicine has regained its pride, and is increasingly where the best doctors choose to have their careers. Today's family physicians include the kindest, and the cleverest, and the most up-to-date, and the most creative members of the medical profession." Having the knowledge and skills is one thing, but to be able to impart it to others and teach them how to be good doctors is even more rewarding, and a challenge to any medical educator.

In the next two to three years, I see myself first and foremost as a doctor, and secondly as a medical educator. My focus of attention had been on two areas, namely, Primary Care Medicine (or Family Medicine) and Medical Education, which have some overlap as there are many things common to both. There is still a lot to do in building up the discipline of Primary Care Medicine and ensuring that the future needs of the country are met in terms of Family Medicine Specialists working in the government health clinics and providing the first line of care. This in turn is dependent on encouraging medical undergraduates to enter the discipline following graduation, so equal care and attention needs to be paid to the undergraduate curriculum.

Christina had this to say about her FAIMER Fellowship:

Being a FAIMER Fellow and having the opportunity to meet fellow medical educators in other countries around the world has been a very enriching experience, and it would be rewarding to share all that I have learned at FAIMER with others. Our university has, in principle, agreed to the setting up of a medical education unit but this has yet to be implemented. I hope to assist in the running of such a unit, and to continue to be active in medical education not only at a local level, but also at national and international levels.

Becoming a FAIMER Fellow has had a more profound impact on me than I could ever possibly have imagined, and I hope I have "grown" not only in terms of learning more about medical education, but also on a personal and professional level. The management tools have been invaluable, and are put into practice every working day. The support provided by the FAIMER "family," who although scattered far and wide across the world are all just an internet click away, has been wonderful, as we can share our experiences, frustrations, and successes.

I feel very fortunate and privileged to be part of this extraordinary community.

FAIMER Fellow Esther Ofoegbu Appointed First Female Head of Department of Medicine, University of Nigeria

On August 1, 2006, Esther Ofoegbu, M.B.Ch.B., M.Sc., F.W.A.C.P., became the first female Head, Department of Medicine, College of Medicine, University of Nigeria, Enugu Campus; and Head, Department of Medicine, University of Nigeria Teaching Hospital, Enugu.

Dr. Ofoegbu has worked for the College of Medicine, University of Nigeria since 1992. Over her 14-year tenure there, she has held a variety of positions, including having served as chairperson or faculty representative of a number of academic committees, coordinator of medical education, and head of the Department of Medicine’s "Think Tank" committee.

Dr. Ofoegbu is no stranger to FAIMER. In 2001, she was awarded a fellowship under the FAIMER International Fellowship in Medical Education (IFME) program when the program provided individual mentorship opportunities. She is currently a FAIMER Institute Fellow from the Class of 2005. Her fellowship project is "Information Technology Utilization in Medical Education."

When asked if her experiences as an IFME and Institute Fellow have had a role in helping her prepare for her new position, Dr. Ofoegbu shared the following reflections:

As an IFME fellow, I undertook a year-long program at the Office of Medical Education, University of Texas Medical Branch (UTMB), Galveston, Texas, from February 2001 to February 2002. This was my first exposure to skills acquisition training in teaching and assessment for problem based learning (PBL). My institution supported me in this program by granting me a sabbatical leave. It was at that period that my institution was giving serious attention to curriculum innovations.

With my return, I became the arrowhead in mobilizing my colleagues for professionalism in medical education and I gained the nickname, "Madame Medical Education."

The FAIMER Institute provided me with experiential learning in leadership and medical school governance, which I have found very useful in my work. The one year distance learning covering relevant medical education topics has equipped me with additional knowledge. My project has enabled me to pursue the task of establishing an office of medical education in my institution through a scientific process with excellent results.

There is no doubt that my IFME and Institute experiences have prepared me adequately for this new position. I now seem to be the resource person on curriculum matters in any meeting of heads of department.

During my IFME and Institute fellowships, I established an enviable network of friends, colleagues, and mentors in medical education. Top of the list are Dr. Gwendie Camp; Ann Frye, Ph.D., Director, Office of Educational Development, UTMB; Diane Heestand, Ed.D., Professor and Director, Office of Educational Development, University of Arkansas for Medical Sciences; Page Morahan, Ph.D., Co-Director of the FAIMER Institute; Bill Burdick, M.D., M.S.Ed., Director of Education and Co-Director of the FAIMER Institute; and FAIMER Fellows from the 2005 and 2004 classes. I am confident that these friends will assist me with advice, suggestions and resources in my new position, whenever I call on them.

Surgeon Ahuka Ona Longombe Reports on His Time at the University of Maastricht

Ahuka Longombe, a 2003 FAIMER Fellow, has been a pioneer in rural health delivery and research, and has reported on his field research to identify alternative surgical materials and equipment in resource constrained rural settings. These strategies include the use of headlights for illumination, fishing line for sutures, locally distilled alcohol as an antiseptic, and placentas as skin grafts following mastectomies. Dr. Longombe has also been a pioneer in introducing rural medicine to students at the University of Kisangani in the Democratic Republic of the Congo, where 80% of the DRC’s population is served by only 20% of the country’s physicians. His findings show that the problems faced in rural areas appear to attract, rather than discourage the students.

Dr. Longombe has just returned from the Netherlands, where he attended the first on-site session of his FAIMER-sponsored fellowship to study for a Masters in Health Professions Education at the University of Maastricht. This two-year Masters program comprises a residential session in the Netherlands each year and approximately 22 months of distance learning from the candidate’s home institution via the Internet. The curriculum includes units devoted to the nature of learning, curriculum and instruction, assessment and evaluation, organization and management, basic and advanced research, design of authentic learning environments, professional development of teachers, and a Masters thesis. He writes of his experience, "I want to thank you very much for this opportunity... I am sure that it will be very helpful for the future of medical education at DR Congo."